How To Survive A Pandemic

This Book Will Surely Enlighten You But There’s No Guarantee You’ll Survive

If you’re looking at the title of Dr. Michael Greger’s latest book, “How To Survive A Pandemic, ” and think that it’s a book about how you personally can survive a pandemic, then you may be disappointed. Sure, there is some well-researched advice on handling yourself during a pandemic, but the majority of the book is both a viral thriller and a cautionary tale arguing that we (and by “we,” I mean the people and government institutions of the world) need to take action on a global scale in order to survive a pandemic.

The book begins with the story of the search for a live sample of the 1918 flu epidemic virus in order to answer a central question that had puzzled virologists for decades: what caused the 1918 flu pandemic which killed 50 million people? A sample was finally obtained in 1997, and, after careful analysis of the sample, it was determined that it was a bird flu.

Avian flu viruses play a central role in the book because research has discovered that birds, especially ducks, are natural carriers of influenza viruses. Since China is the world’s largest duck producer, it has become the epicenter of most modern influenza pandemics. While other animals are likely responsible for previous pandemics such as HIV and Ebola, avian flues tend to attack the respiratory system so they can be easily transmitted through the air. The likelihood of an avian flu virus getting transmitted to humans and then quickly spreading globally has alarmed researchers for at least the last twenty years.

“The domestic duck of Southern China has been considered the principal host of all influenza viruses with pandemic potential. This is probably why two of the last three flu pandemics started in China. “ — Michael Greger

It’s clear that continual close human contact with both industrial farmed and wild animals has caused influenza viruses to jump from animals to humans, but how does it happen? A fair amount of the book tracks modern research and events that illuminate this movement. High density, factory-farmed, chickens and pigs appear to be prime targets in the journey from duck to human as they are processed in the same horrid, cramped conditions as ducks, and often in the same, or nearby, facilities. Factory farming facilities have long been cited as the source of numerous health issues in both domestic farm animals and humans. Global trade and consumption has moved these viruses to every continent.

“The reason french fries can be eaten with abandon without fear of coming down with potato blight is that pathogens adapted to infect plants don’t infect people.” —Michael Greger

Science has documented a large number of avian flu viruses, but Gregor focuses on research and flu incidents surrounding two particularly virulent bird flu strains called H5N1 and H7N9 that were discovered in 1997 and 2013 respectively. They have a respective human fatality rate of around 50% and 40% (for comparison, current estimates of the COVID-19 fatality rate is around 1.4% and the flu associated with the 1918 pandemic has an estimated fatality rate of 2.5%). Fortunately for us, the H5N1 and H7N9 viruses do not have the ability to transmit easily from one human to another. Yet.

“Not long ago, human infection with avian influenza was almost unheard of. Since the emergence of H5N1 in 1997, however, more than a dozen other bird flu viruses have jumped the species barrier to infect thousands of people in more than twenty countries.” — Michael Greger

Avian flu’s ability to mutate quickly in order to gain a survival advantage is the scariest discussion in the book, but also the part well worth understanding if you want to grasp the magnitude of the problem. One of the reasons that modern pandemics are so alarming is that avian flu viruses can transform in response to outside factors like the introduction of anti-viral drugs. The virus can surface in a human host in a form that might have little or no symptoms, or be assumed to be common influenza, but then later mutate into a more virulent form that causes a pandemic. The task of creating a vaccine for this new virus is likely to take many months.

“By mixing H5N1 and human influenza viruses together in a lab, one might be able to estimate how much time we might have left by identifying how many mutations H5N1 may be away from creating a pandemic strain.” —Michael Greger

Whether it’s ducks in China, pigs in the Netherlands, or chicken and turkeys in the U.S. Midwest, the rise of zoonotic diseases can be tracked alongside the increased magnitude of animal agriculture. As countries like the United States, China, Indonesia, Brazil, and the Netherlands keep consolidating and increasing their agricultural animal output, avian-type flu viruses seem to follow. As you might expect, the profit motive of these industrial factory-farming giants often clashes with both common sense and human safety. Greger addresses many questions that might arise from a thoughtful assessment of the link between animal agriculture and avian flu, and shines a light on where these corporations could change for the better.

“To reduce the emergence of viruses like H5N1, humanity must shift toward raising poultry in smaller flocks, under less stressful, less crowded, and more hygienic conditions, with outdoor access, no use of human antivirals, and with an end to the practice of breeding for rapid growth or unnatural egg production at the expense of immunity.” —Michael Greger

The final third of the book delves more directly into how humans and governments can respond once a pandemic, or a likely pandemic, is recognized. It covers some familiar territory — since COVID-19, at least — of the efficacy of social distancing, wearing masks, washing hands, and similar preventative measures, but also takes a macro-view of important issues like data sharing and preparedness plans. The stories of poor government responses to early indications of potential pandemics, along with businesses more interested in profit than saving lives, will seem strangely familiar and yet even more shocking when you consider that some of the biggest problems have been common knowledge for nearly 25 years.

Anyone finishing this 592-page book (don’t worry, the last 250 pages is the list of 3600 references used throughout the book, so it’s really just 342 pages) will find themselves a minor expert on the subject of pandemics and avian flu. There are plenty of tasty citations you can use to debunk your favorite conspiracy theories, and there are some great tips — cold water is generally better than hot water for washing your hands. Who knew? And besides helping you with our current pandemic, “How To Survive A Pandemic” will make you better prepared for future pandemics (spoiler alert: they’re inevitable).

“The silver lining of COVID-19 is that the world will be better prepared for the next global health crisis. Tragically, it may take a pandemic with a virus like H5N1 or H7N9 before the world realizes the true cost of cheap chicken.”—Michael Greger

If you were paying attention to the viral landscape in the year 2006, you might have purchased a copy of Dr. Greger’s previous book on this subject, “Bird Flu: A Virus of Our Own Hatching,” which is currently out of print, but on which “How To Survive A Pandemic” is based. Pandemics are not new, they’re just suddenly popular.